Individual provider Active NPI

Lisa Kaye La Du, MSW, LISW

  • Clinical Social Worker
  • Marietta, OH
National Provider Identifier
1366479784
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0005092 Issued in OH
Practice address
207D Colegate Dr
Marietta, OH 45750
Phone
(740) 376-0930
Fax
(740) 376-0933
NPI assigned
Jun 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I0005092 OH Primary

Addresses

Primary practice location

207D Colegate Dr
Marietta, OH 45750

Mailing address

207D Colegate Dr
Marietta, OH 45750-2363
Phone (740) 376-0930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070911000003 OH Practitioner - Clinical Social Worker 4183717978 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0005092OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hopewell Health Centers, Inc. CurrentSince May 30, 2023 Accepting new patients
Hopewell Health Centers Inc Current Accepting new patients
Hopewell Health Centers Inc CurrentSince May 30, 2023 Accepting new patients
Pfeifer Counseling, Consulting and Training LLC Past Accepting new patients
Behavioral Healthcare Partners of Central Ohio Inc PastSince Feb 10, 2011 Accepting new patients

Locations

90 Hospital Dr
Athens, OH 45701
Phone (740) 592-3091

207 Colegate Dr
#D
Marietta, OH 45750

207 Colegate Dr
Marietta, OH 45750

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1366479784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207D COLEGATE DR",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457502363",
            "telephone_number": "740-376-0930",
            "fax_number": "740-376-0933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207D COLEGATE DR",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "45750",
            "telephone_number": "740-376-0930",
            "fax_number": "740-376-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA DU",
        "first_name": "LISA",
        "middle_name": "KAYE",
        "name_prefix": "Ms.",
        "credential": "MSW, LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0005092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

Verify at the official NPI Registry.